Organization
BROUGHTON ENTERPRISES INC
Active
Other names
Texas State Optical of Lufkin
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA BROUGHTON (BOOKKEEPER)
(936) 632-1119
Entity
Organization
Contact information
Practice address
905 S JOHN REDDITT DR, LUFKIN, TX 75904-4326
(936) 632-1119
(936) 637-7811
Mailing address
905 S JOHN REDDITT DR, LUFKIN, TX 75904-4326
(936) 632-1119
(936) 637-7811
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066437701
—
TX
01
—
16081
PROVIDER ID
TX
01
—
23154
PROVIDER ID
TX
Enumeration date
10/02/2006
Last updated
03/25/2013
Update your record
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